Coding question

Just to clarify there did used to be med management codes for psychiatrists but these have died. (Good) Psychiatrists don't do med management and we should retire the term, hence we use these evaluation and management codes. This is an important distinction because the role of the psychiatrist is to provide ongoing psychiatric evaluation and risk assessment of the patient including consideration of biological, psychological, social, cultural, ethical, and medicolegal factors to develop a comprehensive formulation of the patient to guide management, which may or may not involve prescribing of medications not just fling as many drugs at the patient as possible without evaluating them (sort of implied by the term "med management" which no other field of medicine uses it is used to describe what pharmacists do)

I have heard some psychiatrists argue that we shouldn't even use the psychotherapy alone codes, because even if we are doing straight psychotherapy we are providing psychiatric evaluation and management and should still use the E&M + psychotherapy add ons. However in reality these codes are kind of BS because they are predicated on their being clearly distinguishable portions of the visit that are "E&M" and "psychotherapy" which is of course impossible (or would be weird). I have heard some argue that we should always being using psychotherapy add-on codes because we should always be providing some sort of psychotherapy. Again that is kind of BS in theory, but there isn't anything stopping you from using the psychotherapy add-on codes (I almost always do).

but yeah you should be using 99204/99205/90792 for new evaluations
and 99213/99214 for follow ups with the relevant psychotherapy add on if providing psychotherapy (90833 will be most common)
Remember if seeing family members and using psychotherapy add-on to use the 90875 (interactive complexity) add on in addition

99215 should be used sparingly as this tends to get audited because it should be rarely used in practice. The kind of situation you would use it would be a suicidal patient who needs hospitalization and should be time-based with >50% of time on counseling and coordination of care.

also to clarify if you are using the psychotherapy add on- you cannot use E&M codes based on time, but on elements.

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Coding question